Seminars in thoracic and cardiovascular surgery
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Semin. Thorac. Cardiovasc. Surg. · Jan 1997
The two-patch technique for complete atrioventricular canal.
The goals for repairing complete atrioventricular canal (atrioventricular septal defect) are ventricular septation, atrial septation, mitral valve reconstruction, and tricuspid valve reconstruction. Complications to avoid are heart block, residual septal defects, and dysfunctional atrioventricular valves. The surgical repair of atrioventricular canal has undergone major advances over the past 40 years. ⋯ Perhaps more important than the applied method is that the operation be properly executed to ensure defect closure and competent valves. We review our experience in 120 patients using the two-patch technique with special reference to the technical aspects of the operation. The two-patch technique of repair with routine cleft closure as evaluated by intraoperative transesophageal echocardiography results in a low surgical mortality, a low incidence of permanent heart block, and competent atrioventricular valves.
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Semin. Thorac. Cardiovasc. Surg. · Jan 1997
Late results and reoperation after repair of complete and partial atrioventricular canal defect.
Advances in surgical technique and postoperative care have resulted in substantial improvement in the operative mortality after repair of atrioventricular canal defects. However, significant late morbidity and the need for reoperation complicate the medium and long-term results in these patients. Left atrioventricular valve regurgitation, residual or recurrent intracardiac shunting, and subaortic stenosis are the principle causes of late morbidity after repair of complete and partial atrioventricular canal defects. This article describes the incidence and etiology of these complications, as well as the methods of diagnosis and management.